Romney on Romneycare: First Subsidize, Then Mandate

By Terence P. Jeffrey | February 8, 2012 | 5:37pm EST

Republican presidential candidate, former Massachusetts Gov. Mitt Romney speaks at a campaign rally in Atlanta, Wednesday, Feb. 8, 2012. (AP Photo/Gerald Herbert)

( - In a presentation about his health-care reform plan delivered at the Heritage Foundation on Jan. 6, 2006, then-Massachusetts Gov. Mitt Romney said that for his plan to work it would be necessary to first subsidize health insurance for a segment of the population not already receiving government health-care subsidies and then mandate that everyone in the state buy health insurance.

To do otherwise, Romney said, “would be crazy.” His speech was accompanied by a Powerpoint presentation that graphically laid out some of the basics of his proposal and the health insurance situation that then prevailed in Massachusetts.

On April 12, 2006, three months after he spoke at Heritage, Romney signed his landmark health-care reform proposal into law. The law said that people earning up to 300 percent of the federal poverty level would get subsidies to buy insurance. (The federal poverty level for a family of four is now $23,050, according to the Department of Human Services. That means a family of four earning up $69,150 per year now qualifies for health-insurance subsidies in Massachusetts.)

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“And then, finally, something I am going to call the personal responsibility principle,” Romney told the Heritage Foundation. “You may call this an individual mandate. I don’t. I call it the personal responsibility principle.

“Let me make it real clear: To tell people in our society today that they have to go out and buy insurance would be unfair and wrong. Because right now, they don’t have products they can afford,” said Romney. “And if people are poor, they don’t have any subsidy that they can rely on to help them get a product. So, it would be crazy to say to people, hey, you’re [un]insured, you better go get it. They can’t afford it.

“But once we put in place the reforms I am describing, with new affordable products as well as a subsidized product, where your premium can be as low as $2.30 a week, now everybody can get insurance,” said Romney. “And that’s basically what this slide says. And that is, look, now that we have these products available for you, we want everybody to get insurance and you have responsibility of having insurance, and we are going to mandate that you have insurance.

“Now, how do we mandate it?” said Romney. “Well, I won’t spend a lot of time on this, other than to indicate that we are going to insist that everybody be covered one way or the other and that those who don’t comply have certain problems. They are going to lose their personal tax exemption. We will withhold any of their tax refund. We will keep it in an account at the state level which we will be able to tap to pay the hospital if they go there for free care. The legislature has also put in place consideration of not providing drivers’ licenses to people unless they can show their health insurance coverage, and so forth.

“We also, I just note there, we also, if people go and get free care and don’t pay for it, we go after them,” said Romney. “We garnish wages if we have to make sure that we get paid. People are either going to buy insurance or they are going to pay for their own care. They’re not going to say, I got care and you, Mr. Taxpayer, or you Mrs. Premium Payer, you have to pay for me.”

Later in the presentation, Romney said: “The money follows the person not the institution. We give money to individuals to allow them to buy insurance. We do not give Medicaid money to hospitals, and say, gosh, you got a lot of uninsured that you care for so we are going to give you a check this year for $50 million.  No, the state and the federal government give the money to individuals to buy insurance and they get to go to whichever providers they want to go to.”

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